While it’s not clear what causes migraines, one of their lasting effects may be brain lesions triggered by poor blood flow.

Researchers report in the Journal of the American Medical Association (JAMA) that women, who are three times as likely as men to experience migraines, may suffer from other consequences of the painful headaches apart from the common symptoms of nausea, vomiting and sensitivity to light. Women who have migraines are twice as likely as non-sufferers to show structural changes, or lesions, due to inadequate blood flow in certain parts of the brain.

The role that these lesions may play in health, however, still aren’t obvious. “Patients should not live with the idea that each migraine attack is potentially ‘damaging’ their brains,” corresponding study author Mark Kruit says in an email to TIME discussing the results. “Patients should know that the [volume] of changes is small, and that they are not related to worse cognitive function. [T]here is no need for changes in the way migraine patients are treated, based on the study results.”

Previous MRI brain scans of migraine patients found unusual “hyperintensities” — bright areas suggesting areas of poor blood flow. But those studies could not determine which came first — whether people with migraines tend to develop brain lesions, or whether the brain lesions trigger migraines. Those studies also could not track whether each successive migraine would expand the size of the brain lesions, leading to worsening symptoms.

So Kruit, a radiologist and neurologist working in Leiden in the Netherlands, joined with a Dutch team of doctors to study migraine in nearly 300 adults living in that country. Most of the participants suffered from migraines, but some did not. Researchers scanned the brains of all of the participants at the start of the study, in 2000, and again in 2009. By comparing the images taken in the same year, Kruit and his colleagues could measure differences in brain lesions between the migraine patients and those who did not suffer from the headaches. And by comparing scans for the same patients taken nine years apart, they could also record whether those with migraine history are more likely to develop new brain lesions over time, whether existing lesions grow faster among people with more migraine attacks, or whether the lesions are linked to declines in cognitive skills.

The researchers found no difference in outcomes among men. Both men with migraines and those without the headaches were equally likely to show hyperintensities on the MRI scans.

But it was a different story for the women. Both in 2000 and in 2009, women with migraines had higher lesion volume than those without migraines, and during the study period their lesions also progressed faster than those among women without migraines. However, the growth of these lesions was not associated with the frequency or intensity of migraines, or to the presence of aura — the vision disturbances and other sensory changes that may precede migraine headaches. That, say the researchers, suggests that the lesions are not part of the collateral damage resulting from the migraine attacks but rather related to whatever is responsible for the headaches.

The lesions that were especially common among women with migraine are called deep white matter hyperintensities. These have been linked in the past to dementia and stroke, but when the Dutch researchers conducted cognitive tests on the migraine participants, they did not observe any declines in cognitive ability or increased stroke risk among headache sufferers in their study relative to those without migraine.

So while women who experience migraines are more likely than other women to develop unusual structural changes in the brain, those changes don’t appear to have any clinical effect.

In fact, as Dr. Deborah Friedman, a neurologist at University of Texas Southwester Medical Center and Dr. David Dodick, in the department of neurology at Mayo Clinic, write in an editorial accompanying the study, the results may actually be “reassuring for patients and their physicians on several levels” since “the overall lesion burden was quite small and most likely clinically insignificant.”

Still, the link between migraines and brain lesions warrants more study, since they appear to be connected to the root cause of the headaches and may help scientists to understand the biology behind them. And that may ultimately lead to better treatments as well.

I have been suffering from migraines for several years I would say about 28 years. My migraines are always on the right side of my head, right over my right eye and back. So, so painful. At the age of 50 I was having a terrible migraine at work when all of sudden I forgot where I was, who I was. I was completely dazed and confused. I was brought to the hospital and was diagnosed with epilepsy. My neurologist found in my MRI found blunt trauma scare tissue and above my right ear the MRI was showing a dead spot on the brain. I wasn't shocked as, I was in a relationship in which I was beaten on a daily basis. However, she doesn't feel that, that is the total cause of my migraines. I can honestly say that I wish that there was a cure for migraines as, they can ruin my entire day or week. There are many more tests that I need to go through however, I really don't think that my migraines are going to stop. They are horrible. Those of us that have them are really stuck in a rut. There have been so many times that I have out having a nice time and here comes an uninvited migraine and I have to go home. There has to be something that can help. I have made Excedrin Migraine rich. My prayers to all of my fellow sufferers.

So, have been having periodic memory issues which prompted the MRI scan--impression was : "moderate subcortical white matter changes bilaterally and co fluent left parieto-occipital region. This may be seen in patients with micro vascular ischemic change, migraine headache, vadculitis, or post infection."

I hadn't had a recent infection, nor ever had a migraine--

Could I have had a 'mini stroke' and not even known it?

They did the NeuroQuant test which came back normal--but it doesn't address my memory lapses.

I am a 29 y/o female. Monday I returned to the neurologist for MRI follow up apt and any answers they could give me about my migraines. They found a small area of plaque on the left side of my brain which is where I usually get the most pain. They said not to worry about it and that it is not connected to anything major or long term that it is just a result and a sign that in fact I am having migraines not just sinus headaches. Also, they had done a bunch of blood work as well. They found the I have a B12 deficiency and started me on self administered B12 shots. They say that this can be the cause of my migraines. Also, I have had 2 miscarriages in the past year and found that B12 deficiency can be the cause of multiple miscarriages. Im hoping that this is the answer to my prayers and solves my problems. So far it seems to be working. I haven't had any migraines or migraine symptoms, which had become a regular occurrence. I also have had a lot more energy so fingers crossed that this is the stone that I need to kill both birds so to speak. I also hope this may help someone else. It doesn't hurt to get an extra blood test done to check your B12 levels...something they don't normally check for so you will have to ask.

fresh air has therapeutic benefits and it never fails. Drinking water also helps. Dehydration is a common cause of migraine. But if you think that there's something serious going on it's time to consult your doctor. My friends have asked me to visit http://drariasabit.blogspot.com/

I have been a migraine suffer since I was ten years old and have experienced them for the good majority of my life. The headaches really intensified when I was 28yo and remained chronic daily migraines until I turned 49. I think that I have tried it all for the most part. I am a retired pharmacist so I was always pumping the Drug Representatives about any new research. I have been called crazy because men do not get chronic daily migraines. I have been called a drug seeker and a liar. Oddly enough, it was always the ER docs who would step up to the plate and treat me the best. This type of migraine is apparently genetic as my mom and my older brother have also suffered with these headaches. I do not wish these headaches on anyone, even my worst enemy because they are debilitating and the pain steals time from you life, and family. I have been aware of these lesions within the brain for about ten years now, so apparently they now have more definitive research to actually say this happens, That is great and it helps confirm that the stroke that I had in January of 2006 was due to the migraine and not my blood pressure. To all those who suffer from these debilitating headaches, my heart goes out to you.

I've suffered with migraines since 2005. In 2010 I had one for 32 days straight, was hospitalized and put on IV. 2 months ago someone told me about vitamin B2 Roboflavin. I take 200mg in the morning and 200mg in the evening. I haven't had a migraine since. I had to have the pharmacy order them for me, as they don't keep them on the shelf in the stores. It is definitely worth trying. I know it is working for me and I will not get off of them.

I was almost bedridden with daily migraines, until I found out my trigger was Canola Oil/Rape Seed. Be aware of this oil if you suffer migraines ; It'd be worth considering it as a trigger-it wasn't easy to figure out. I begin a migraine within minutes of consuming it and I can't possibly be the only person who it has this effect on. It is made from Rape Seed, so all but a few peanut butters include rape seed. It seems as though the majority of restaurants cook with Canola Oil too. It is in so much of our food, some PAM Cooking Spray, tons of snack food like Ruffles, chips, bread, etc., etc. Since finding out this trigger, I at least have my life back. It's a real trick to avoid it though.

I had a brain scan once and the specialist found my brain rittled with these. Said he had never before in his career seen such a thing. I suffered for years with severe severe migraines. Still do from time to time.

Mitochondrial Encephalopathy! Mitochondria are needed for energy production in every cell, when the mitochondria are not working well in the brain tissue, migraines or seizures can occur as well as cell death.